Continuing Care Retirement Communities NAICS 623311
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Industry Summary
The 3,731 Continuing care retirement communities (CCRCs) in the US provide assisted living with on-site skilled nursing facilities, independent living, assisted living, and skilled nursing services either on campus or at nearby facilities. These facilities involve a contract each resident signs, entitling them to a continuum of care in exchange for payment of an entrance fee and ongoing monthly fees.
Sensitivity to Capital Markets
Difficulty in obtaining financing or in re-financing existing debt can force CCRCs to delay needed renovations, postpone planned expansions, or prevent them from breaking ground.
Demographic Trends Grow Demand
Since January 2011, baby boomers have been turning age 65 at a rate of 10,000 per day - and this will continue for 20 years.
Recent Developments
Jul 8, 2025 - Top Salary Gains Go To Nursing Directors
- Pay for directors of nursing at continuing care retirement communities (CCRCs) increased 4.07% in 2025, according to The Hospital & Healthcare Compensation Service’s 2025-2026 CCRC Salary & Benefits Report. The increase occurred even as salaries and hourly wages moderated overall across most campuses. Registered nurse salaries increased by 3.59% (down from 5.28% in 2024), while licensed practical nurses received an average of 3.43% more (down from 5.04% in 2024). Certified nurse aides received an average hourly increase of 3.96% this year (down from a 5.03% increase in 2024). Even with the moderation, averages in the 3.5% to 4% range indicate that CCRCs recognize the importance of clinical roles and want to ensure their compensation is competitive, according to Matt Leach, principal and senior consultant with Total Compensation Solutions. Some wage increases may be due to day-to-day competition with other local providers, which could include other CCRCs, peer nursing homes, or hospitals when it comes to RNs. Nursing directors can be especially hard to recruit, Leach told McKnight’s Long-Term Care News.
- Industry stakeholders including providers and residents’ groups are cooperating to ensure the financial strength of continuing care retirement communities (CCRCs), according to McKnight's Long-term Care News. The move follows several nationwide bankruptcies that resulted in millions of dollars in lost entrance fees. “Since CCRCs require substantial resident investment, appropriate regulatory safeguards are needed to ensure promises made are promises kept," said Pat Burdsall, Florida Life Care Residents Association (FLiCRA) board president and resident at Indian River Estates in Vero Beach. Some of FLiCRA’s goals include revisiting current legislation to ensure the state is equipped to assist finally strapped CCRCs to protect residents’ assets, creating balanced regulatory standards that consider needed industry oversight and the operational needs of CCRCs, and backing “fair and transparent” laws that promote lasting stability for providers and residents.
- Some continuing care retirement communities (CCRCs) have found it difficult to maintain adequate skilled nursing staffing levels, according to Kiplinger.com Increasing labor costs and inadequate Medicare reimbursement rates are key causes of staffing shortages. The average cost to live in a CCRC is around $350,000, according to Kiplingers, and that’s just the entry fee. The Monthly Service Fee adds another $3,500 to $4,500 a month to the bill.
- Nursing and residential care industry revenue increased 8.7% year over year and 4.5% quarter over quarter during the fourth quarter of 2024, according to the US Census Bureau. Continuing care retirement community industry employment increased slightly and average wages for nonsupervisory employees decreased slightly during the first five months of 2025, according to the US Bureau of Labor Statistics. Continuing care retirement community industry sales are forecast to grow at a 4.73% compounded annual rate from 2025 to 2029, faster than the growth of the overall economy, according to Inforum and the Interindustry Economic Research Fund, Inc.
Industry Revenue
Continuing Care Retirement Communities
Industry Structure
Industry size & Structure
The average CCRC has about 130 employees and generates $11 million in annual revenue.
- There are about 3,731 CCRC firms in the US operating 5,506 facilities with $41 billion in annual revenue and 485,800 employees.
- About half of facilities are "true" CCRCs offering care from independent living through skilled nursing under a contract that guarantees a continuum of care in exchange for an entrance fee and ongoing monthly fees.
- About half of "true" CCRCs are affiliated with faith-based organizations, such as Presbyterian, Lutheran, Methodist, or Catholic churches.
- Companies that own and operate multiple communities include Life Care Services and Erickson Living.
- CCRCs are located in a range of geographical areas from urban to suburban to rural.
Industry Forecast
Industry Forecast
Continuing Care Retirement Communities Industry Growth
Source: Vertical IQ and Inforum
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